JMIR Publications

JMIR Preprints


Currently submitted to: Journal of Medical Internet Research

Date Submitted: Sep 20, 2017
Open Peer Review Period: Sep 21, 2017 - Nov 16, 2017

NOTE: This is an unreviewed Preprint

Peer-Review Me

Evaluation of a smartphone-based intervention to increase parents’ knowledge about the MMR vaccination and their psychological empowerment: A mixed method approach.

  • Marta Fadda; 
  • Elisa Galimberti; 
  • Maddalena Fiordelli; 
  • Peter Johannes Schulz



There is mixed evidence on the effectiveness of vaccination-related interventions. A major limitation of most interventions is that they lack a rigorous evaluative assessment which is partly due to the fact that, over the last two decades, randomized controlled trials have been increasingly considered as the only proof of the effectiveness of an intervention and, consequently, as the most important instrument in deciding whether to adopt an intervention or not.


The aim of this study is to evaluate two smartphone-based interventions aimed at increasing parents’ knowledge of the MMR vaccination (through elements of gamification) and their psychological empowerment (through the use of narratives), respectively. The two interventions were part of a randomized controlled trial.


We conducted two studies with the RCT participants: an online survey aimed at assessing their rating of the tool regarding a number of qualities, such as usability and usefulness, and qualitative telephone interviews to explore participants’ experiences with the application.


The results of the survey showed that participants receiving the knowledge intervention (alone or together with the empowerment one) liked the app significantly better compared to the group that only received the empowerment intervention. Parents receiving the empowerment intervention complained that they did not receive useful information but were only invited to make an informed, autonomous MMR vaccination decision.


The results suggest that empowering efforts should always be accompanied by the provision of factual information. Using a narrative format that promotes parents’ identification can be an appropriate strategy, but it should be employed together with the presentation of more points of views and notions regarding, for instance, the risks and benefits of the vaccination at the same time.